HSC Section 8_April 2017

Electroneurography for Facial Palsy

is useful to predict the prognosis only during the first 2 weeks after the onset. After then, accurate prediction using ENoG is difficult because the regeneration process already begins at the proximal end or the collateral neural circuit can develop from a healthy nerve around a degenerated nerve. Conclusion ENoG is considered the most valuable test to predict the prognosis and its main indication is acute complete facial pa- ralysis. Both the percentage degeneration and rate of degen- eration are prognostic indicators. In Bell’s palsy, percentage degeneration of more than 90% within 14 days post-onset of complete paralysis indicates poor prognosis in more than 50% of cases. Although electrophysiological tests provide useful neuro- physiological information and serve as a guide to the man- agement of acute facial paralysis, they have some limitations. They cannot distinguish between axonotmesis and neurot- mesis and are not useful in cases of incomplete paralysis. In addition, they cannot give any useful information within first 72 hours after the onset. Conflicts of interest The author has no financial conflicts of interest. REFERENCES 1) Mattox DE. Clinical disorders of the facial nerve. In: Flint PW, Haugh- ey BH, Lund VJ, Niparko JK, Richardson MA, Robbins KT, et al., editors. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Science Health Science;2014. p.2617-28. 2) Linstrom CJ. Objective facial motion analysis in patients with facial nerve dysfunction. Laryngoscope 2002;112(7 Pt 1):1129-47. 3) Neely JG, Wang KX, Shapland CA, Sehizadeh A, Wang A. Com- puterized objective measurement of facial motion: normal variation and test-retest reliability. Otol Neurotol 2010;31:1488-92. 4) Frey M, Tzou CH, Michaelidou M, Pona I, Hold A, Placheta E, et al. 3D video analysis of facial movements. Facial Plast Surg Clin North Am 2011;19:639-46, viii. 5) Hadlock TA, Urban LS. Toward a universal, automated facial mea- surement tool in facial reanimation. Arch Facial Plast Surg 2012;14: 277-82. 6) Esslen E. Electrodiagnosis of facial palsy. In: Miehlke A, editor. Surgery of the Facial Nerve. Philadelphia, PA: W.B. Saunders;1973.

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